Question AWV via Audio only during Covid PHE?

lemorris

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I am looking for any guidance on billing for AWV done via telephone only. I have seen some info that CMS loosened the requirements during the Covid PHE to allow AWV via audio/visual, but nothing specific to audio only. Also has anyone seen guidance on if either of these scenarios would require the teleheath modifer?

Thank You - Lea M
 

b.cobuzzi

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The patient can give you the vitals verbally. If the patient is unable to give you vitals, the AWV cannot be completed. This was told to us during the CMS Office Hours one Tuesday or Thursday evening.
 
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The patient can give you the vitals verbally. If the patient is unable to give you vitals, the AWV cannot be completed. This was told to us during the CMS Office Hours one Tuesday or Thursday evening.
I understand the vitals and am not questioning that. I am questioning can we bill the go438 or g0439 codes when doing an audio only visit or must the audio only codes be used. I believe the audio only codes must be billed even if all the requirements are met via phone audio only.

this has been a long discussed issue at my work and I want verification from cms that the g codes can be billed with an audio only call. Not just that the requirements can be met.
 
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I have read through all the transcripts on there that I can find. I found where it was brought up and said it would be looked into and addressed later but haven’t seen an update. I have seen several on the facility fee g code but not billing annual wellness g code??
 

b.cobuzzi

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You may want to look through the COVID FAQ that was just updated by CMS on June 19.
You can download the PDF by Googling:
CMS COVID-19 FAQ Updated June 19
 

b.cobuzzi

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Interestingly, in the last CMS Office Hours (June 30), it was said that they believed that AWV could not be coded if the patient did not have the monitors to check their vitals (BP cuff, scale, etc) and if that is the case, the AWV could not be billed. But they are looking into it and would get back to it.

And then today, July 1st, during a webinar by NGS (MAC), they said that if the patient cannot relate their vitals, the provider just has to document why the vitals cannot be captured in the note and then the AWV can be code and be billed. However, they said, given what they heard on the CMS Office Hours call on Tuesday, this rule may be rescinded if CMS comes back at a later date, and says that the AWV cannot be billed and coded definitively when there are no vitals captured.
 
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